Abstract
BackgroundWe aimed to assess, for the first time, the nature of the indoor air contamination of hospitals.Methods and FindingsMore than 40 volatile organic compounds (VOCs) including aliphatic, aromatic and halogenated hydrocarbons, aldehydes, alcohols, ketones, ethers and terpenes were measured in a teaching hospital in France, from sampling in six sampling sites – reception hall, patient room, nursing care, post-anesthesia care unit, parasitology-mycology laboratory and flexible endoscope disinfection unit – in the morning and in the afternoon, during three consecutive days. Our results showed that the main compounds found in indoor air were alcohols (arithmetic means ± SD: 928±958 µg/m3 and 47.9±52.2 µg/m3 for ethanol and isopropanol, respectively), ethers (75.6±157 µg/m3 for ether) and ketones (22.6±20.6 µg/m3 for acetone). Concentrations levels of aromatic and halogenated hydrocarbons, ketones, aldehydes and limonene were widely variable between sampling sites, due to building age and type of products used according to health activities conducted in each site. A high temporal variability was observed in concentrations of alcohols, probably due to the intensive use of alcohol-based hand rubs in all sites. Qualitative analysis of air samples led to the identification of other compounds, including siloxanes (hexamethyldisiloxane, octamethyltrisiloxane, decamethylcyclopentasiloxane), anesthetic gases (sevoflurane, desflurane), aliphatic hydrocarbons (butane), esters (ethylacetate), terpenes (camphor, α-bisabolol), aldehydes (benzaldehyde) and organic acids (benzoic acid) depending on sites.ConclusionFor all compounds, concentrations measured were lower than concentrations known to be harmful in humans. However, results showed that indoor air of sampling locations contains a complex mixture of VOCs. Further multicenter studies are required to compare these results. A full understanding of the exposure of healthcare workers and patients to complex mixtures of chemical compounds can then be related to potential health outcomes.
Highlights
Besides microbial contamination with hundreds of research papers in relation to hospital-acquired infections, the chemical contamination of indoor air in hospitals is rarely studied
Dascalaki et al [7] have reported an average concentration of 8,8862 mg/m3 for total volatile organic compounds (TVOC) in operating rooms with a contamination dominated by anesthetic gases
Air samples were collected in six sites of the hospital – the reception hall, a patient room, a nursing care, the parasitologymycology laboratory, a post-anesthesia care unit (PACU), and the flexible endoscope disinfection unit – in order to estimate the spatial variability in VOCs concentrations in indoor air
Summary
Besides microbial contamination with hundreds of research papers in relation to hospital-acquired infections, the chemical contamination of indoor air in hospitals is rarely studied. Taking into account the specificity of hospital activities, healthcare workers (HCWs) and patients may be exposed to a wide range of chemical compounds emitted from various products such as disinfectants and sterilitants (ethylene oxide, glutaraldehyde, formaldehyde, alcohols...), anesthetic gases, laboratory or pharmaceutical products [1]. Some studies have shown that HCWs reported more indoor air-related symptoms than people working in office buildings [2]. Most of studies have assessed the exposure of HCWs only to a few compounds such as anesthetic gases (operating rooms), formaldehyde (pathology laboratories), or glutaratldehyde and ethylene oxide (disinfection units). Dascalaki et al [7] have reported an average concentration of 8,8862 mg/m3 for total volatile organic compounds (TVOC) in operating rooms with a contamination dominated by anesthetic gases (isoflurane and sevoflurane). For the first time, the nature of the indoor air contamination of hospitals
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